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Background. Hereditary renal tubular disorders (HRTD) represent a group of genetic diseases characterized by disturbances in fluid, electrolyte, and acid-base homeostasis. There is a paucity of studies on pediatric HRTD in Egypt. In this study, we aimed to study the pattern, characteristics, and growth outcome of HRTD at an Egyptian medical center. Methods. This study included children from one month to < 18-years of age with HRTD who were diagnosed and followed up at the Pediatric Nephrology Unit of Sohag University Hospital from January 2015 to December 2021. Data on patients` demographics, clinical features, growth profiles, and laboratory characteristics were collected. Results. Fifty-eight children (57% males; 72% parental consanguinity; 60% positive family history) were diagnosed with seven HRTD types. The most commonly encountered disorders were distal renal tubular acidosis (distal renal tubular acidosis [RTA] 27 cases, 46.6%) and Bartter syndrome (16 cases 27.6%). Other identified disorders were Fanconi syndrome (6 cases with cystinosis), isolated proximal RTA (4 cases), nephrogenic diabetes insipidus (3 cases), and one case for each RTA type IV and Gitelman syndrome. The median age at diagnosis was 17 months with a variable diagnostic delay. The most common presenting features were failure to thrive (91.4%), developmental delay (79.3%), and dehydration episodes (72.4%). Most children showed marked improvement in growth parameters in response to appropriate management, except for cases with Fanconi syndrome. Last, only one case (with cystinosis) developed end-stage kidney disease. Conclusions. HRTD (most commonly distal RTA and Bartter syndrome) could be relatively common among Egyptian children, and the diagnosis seems challenging and often delayed.

Skin cancer is one of most deadly diseases in humans. According to the high similarity between melanoma and nevus lesions, physicians take much more time to investigate these lesions. The automated classification of skin lesions will save effort, time and human life. The purpose of this paper is to present an automatic skin lesions classification system with higher classification rate using the theory of transfer learning and the pre-trained deep neural network. The transfer learning has been applied to the Alex-net in different ways, including fine-tuning the weights of the architecture, replacing the classification layer with a softmax layer that works with two or three kinds of skin lesions, and augmenting dataset by fixed and random rotation angles. The new softmax layer has the ability to classify the segmented color image lesions into melanoma and nevus or into melanoma, seborrheic keratosis, and nevus. The three well-known datasets, MED-NODE, Derm (IS & Quest) and ISIC, are used in testing and verifying the proposed method. The proposed DCNN weights have been fine-tuned using the training and testing dataset from ISIC in addition to 10-fold cross validation for MED-NODE and DermIS-DermQuest. The accuracy, sensitivity, specificity, and precision measures are used to evaluate the performance of the proposed method and the existing methods. For the datasets, MED-NODE, Derm (IS & Quest) and ISIC, the proposed method has achieved accuracy percentages of 96.86%, 97.70%, and 95.91% respectively. The performance of the proposed method has outperformed the performance of the existing classification methods of skin cancer.

Abstract Familial hypercholesterolemia (FH) is a world public health problem that enhances the risk of premature coronary artery disease (CAD) with a high incidence of acute coronary syndrome. This study aimed to evaluate the clinical and angiographic characteristics of the patients with and without FH who had ST-elevation myocardial infarction (STEMI). It included 690 patients who presented with the first attack of STEMI and underwent primary percutaneous coronary interventions (PPCI). The patients were analyzed to diagnose FH according to the Dutch Lipid Clinic Network (DLCN) criteria. All angiograms were analyzed for the number of diseased vessels, Syntax score, thrombus burden grade, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade. The majority of patients were male (72.6%) with a mean age of 54 ± 12 years. Based on DLCN criteria, they were classified into unlikely/possible FH (86.1%) and probable/definite FH (13.9%) groups. Probable/definite FH patients were significantly younger, and higher incidence of males

Abstract This study proposes a new deep-learning approach incorporating a superfluity mechanism to categorize knee X-ray images into osteoporosis, osteopenia, and normal classes. The superfluity mechanism suggests the use of two distinct types of blocks. The rationale is that, unlike a conventional serially stacked layer, the superfluity concept involves concatenating multiple layers, enabling features to flow into two branches rather than a single branch. Two knee datasets have been utilized for training, validating, and testing the proposed model. We use transfer learning with two pre-trained models, AlexNet and ResNet50, comparing the results with those of the proposed model. The results indicate that the performance of the pre-trained models, namely AlexNet and ResNet50, was inferior to that of the proposed Superfluity DL architecture. The Superfluity DL model demonstrated the highest accuracy (85.42% for dataset1 and 79.39% for dataset2) among all the pre-trained models.

Abstract Moyamoya disease (MMD) is a chronic, rare cerebrovascular disorder of unknown cause featured by extensive narrowing of the terminal internal carotid artery (ICA) and its main branches. As a compensatory mechanism, perforators dilate forming fragile collateral vessels that appear as an abnormal vascular network resembling ‘puff of smoke drifting in the air’ observed via angiography around stenotic area in the brain. Patients and methods The database of the current hospital was retrospectively studied. All patients with ischemic strokes owing to MMD treated with surgical revascularization between January 2015 and December 2022 were included. MMD was identified on catheter-based digital subtraction angiography (DSA) by the presence of stenosis at the terminal portions of both internal carotid arteries and the development of abnormal collateral “moyamoya vessels” around the base of the brain. Clinical, radiological and follow-up data were retrospectively analyzed. Results During the mentioned time window, nine patients were diagnosed with moyamoya disease among all pediatric patients with established diagnosis of ischemic stroke in our institute; six of them underwent surgery. Unilateral EDMS was performed in 5 cases (83.3%), while one patient (16.67%) underwent staged bilateral surgeries with no added neurological deficit. Conclusion Indirect revascularization surgery for pediatric moyamoya-related stroke patients has high rates of reperfusion and promising outcomes.

External and internal architecture is distinguished from all arts in that it deals with the basic three dimensions "length, width, and height" as well as the fourth dimension, which is time. In the art of photography, for example, man deals with two dimensions in addition to the dimension of time, but the person remains outside all these works, looking at and watching them. As for architecture, it represents a huge structural sculptural piece that a person approaches, enters, and walks in enjoying, examining it at all levels in a chronological sequence and within a certain schematic scale. The design thought shows the possibility of implementing paper folding designs with alternative industrial materials, such as: paper, cardboard, rubber, polyvinyl chloride, polypropylene, polyethylene, fabrics, and natural materials, such as: leather, copper, aluminum, plywood, which led to an expansion Scope of using paper folding technology to form larger, thicker and more intense models. The design process relied on this approach, which was represented in achieving the values of the creative thought of interior design derived from the folding technique, and how to deal with interior design vocabulary dynamically so that it was possible to solve interior design problems inspired by the art of folding through a global perspective consistent with the principles of contemporary thought. Spectral process means the physics of adaptation in the theory of chaos or disasters, while in architecture, the concept of folding expresses a technique of origami art, which is the process of bending one layer upon another layer, and while the folding process appears as if in its content a process of repetition of the form, it is theoretically considered a subjective process As it does not delete or add any elements that make up the shape, and it is considered a precise process that addresses one of the most quality characteristics of the shape, which is the transition from one dimension to another (the second dimension to the third dimension), and it is also a process that involves changes that expand the geometric qualities of the element while maintaining with its topology.

Knee Osteoarthritis (OA) is one of the most common joint diseases that may cause physical disability associated with a significant personal and socioeconomic burden. X-ray imaging is the cheapest and most common method to detect Knee (OA). Accurate classification of knee OA can help physicians manage treatment efficiently and slow knee OA progression. This study aims to classify knee OA X-ray images according to anatomical types, such as uni or bicompartmental. The study proposes a deep learning model for classifying uni or bicompartmental knee OA based on redefined residual learning with CNN. The proposed model was trained, validated, and tested on a dataset containing 733 knee X-ray images (331 normal Knee images, 205 unicompartmental, and 197 bicompartmental knee images). The results show 61.81 % and 68.33 % for accuracy and specificity, respectively. Then, the performance of the proposed model was compared with different pre-trained CNNs. The proposed model achieved better results than all pre-trained CNNs.

Abstract The operation and effectiveness of a solar-powered underground water pumping system are affected by many environmental and technical factors. The impact of these factors must be investigated to be considered when developing these systems and to ensure their dependability. This study evaluated the dependability and performance of photovoltaic water pumping system (PVWPS) under real operating conditions by examining the effects of solar irradiance, panels’ temperature, and components' efficiency. From December 2020 to June 2021, experiments were conducted on a 10 hp PVWPS located in Bani Salamah, Al-Qanater-Giza Governorate, Egypt, at latitude 30.3° N, longitude 30.8° E, and 19 m above sea level. The irradiance values reached 755.7, 792.7, and 805.7 W/m2 at 12:00 p.m. in December, March, and June, respectively. Furthermore, the irradiance has a significant impact on the pump flow rate, as the amount of pumped water during the day reached 129, 164.1, and 181.8 m3/day, respectively. The panels' temperatures rose to 35.7 °C, 39.9 °C, and 44 °C, respectively. It was observed that when the temperature rises by 1 degree Celsius, efficiency falls by 0.48%. The average efficiency of photovoltaic solar panels reached its highest value in March (13.8%) and its lowest value in December (13%).

Abstract Human Skin cancer is commonly detected visually through clinical screening followed by a dermoscopic examination. However, automated skin lesion classification remains challenging due to the visual similarities between benign and melanoma lesions. In this work, the authors proposed a new Artificial Intelligence-Based method to classify skin lesions. In this method, we used Residual Deep Convolution Neural Network. We implemented several convolution filters for multi-layer feature extraction and cross-channel correlation by sliding dot product filters instead of sliding filters along the horizontal axis. The proposed method overcomes the imbalanced dataset problem by converting the dataset from image and label to vector of image and weight. The proposed method is tested and evaluated using the challenging datasets ISIC-2019 & ISIC-2020. It outperformed the existing deep convolutional networks in the multiclass classification of skin lesions. Graphical Abstract

The study aimed to invest the techniques and methods of Handicraft with a technical and functional diversity of the ores of Arjoun and the palm leaf as plastic media with a comparative and competitive advantage to develop Folk handicrafts and develop the skills of students, craftsmen and youth in Aswan Governorate, where field visits to craftsmen and training workshops to encourage women and girls to environmental practices and the application of plastic methods, and the study adopted the curriculum. Semi-experimental and applied, and recommended to support talents in specialized colleges and schools through specialized workshops and training courses to develop their talents to be a nucleus for trainers for some trades that rely on sustainable environment materials, and to encourage young people to establish small and medium enterprises as a comparative and competitive advantage in society that helps economic progress and increase exports.Results: -Arjun and Al-Nakhil Leaves could be formed for the people of Aswan and Nubia and students of the Faculty of Specific Education, to become one of the subsistence industries in the field of handicrafts with relative and competitive distinction.Activating the role of technical works in developing the skills of plastic employment in a technical and functional diversity in the two ores of Arjun and Palm Leaves in thefield of handicrafts with relative and competitive distinction.Activating the role of technical works in developing the skills of plastic employment in a technical and functional diversity in the two ores of Arjun and Palm Leaves in the field of handicrafts, and forming a data bank by communicating with the designated bodies to provide free advisory services to craftsmen and youth.Implementing workshops and exhibitions that benefit students, young people without specialists, and the breadwinner woman as a competitive distinction that achieves occupations that keep pace with the needs of the labor market, reduce unemployment, and open a field for profit competition from available local materials.Recommendations:Directing youth projects towards the application of techniques for working with palm waste in the production of tourist crafts aimed at preserving and improving the environment and helping to eliminate them safely.

One of the problems of tunnels is lacking enough fresh air for passengers inside the subway. Also, as a result of the friction of the train with the railways inside the tunnel, high heat is generated. So, the design and calculation of an efficient ventilation system are critical for the tunnels. There are several methods used to determine the most effective tunnel ventilation systems while reducing fan energy costs, including their operating performance. The main task of an optimal tunnel ventilation system is to determine the quantity, location, and function of fans to distribute the required fresh air flow at the lowest possible cost. The main parameters for selecting a suitable fan that meet the optimal design of the tunnel ventilation system are the ventilation rate (Q) and the static head pressure (H). Both Q and H of Cairo Metro Line 3 were studied and calculated under different conditions of ventilation design from the obtained data. The amount of the ventilation rate by the fan was taken 80 m3/s which is the actual air flow rate taken from data of the National authority of Cairo Metro No.3. In addition, a comparison is made between various methods to determine the most effective tunnel ventilation system. The static head pressure( H )was calculated. According to the American Brattice Cloth (ABC) rigid duct method, the static head equals to 1171.5Pa , which is the most economical value that is giving the lower power consumption and rate of ventilation.

Familial hypercholesterolemia (FH) is a world public health problem that enhances the risk of premature coronary artery disease (CAD) with a high incidence of acute coronary syndrome. This study aimed to evaluate the clinical and angiographic characteristics of the patients with and without FH who had ST-elevation myocardial infarction (STEMI). It included 690 patients who presented with the first attack of STEMI and underwent primary percutaneous coronary interventions (PPCI). The patients were analyzed to diagnose FH according to the Dutch Lipid Clinic Network (DLCN) criteria. All angiograms were analyzed for the number of diseased vessels, Syntax score, thrombus burden grade, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade. The majority of patients were male (72.6%) with a mean age of 54 ± 12 years. Based on DLCN criteria, they were classified into unlikely/possible FH (86.1%) and probable/definite FH (13.9%) groups. Probable/definite FH patients were significantly younger, and higher incidence of males < 55 years compared with unlikely/possible FH patients (p < 0.001 for each). Moreover, probable/definite FH patients had a higher frequency of three-vessel disease (p = 0.007) and Syntax score (p < 0.001) with a moderate positive correlation with the DLCN score (r = 0.592, p < 0.001). Furthermore, probable/definite FH patients showed a higher thrombus burden and final TIMI slow/no-reflow when compared to the unlikely/possible FH patients (p = 0.006 and p = 0.027, respectively). Patients with probable/definite FH and LDL-C level were independent predictors of high thrombus burden besides males < 55 years, and the number of diseased vessels. In conclusion, STEMI patients with FH were younger males and associated with severe CAD with frequent multivessel CAD, high anatomical complexity of CAD, and frequent high thrombus burden. Furthermore, FH was one of the predictors of high thrombus burden. [ABSTRACT FROM AUTHOR]

Lead acetate is the most common coagulant used in quality control laboratories in the sugar industry to clarify juice samples. Due to its known poisonous effects, health hazards, and extremely harmful impact on the environment, this study focused on finding an alternative coagulant that was efficient, safe, cost-effective, and eco-friendly. A powder made from Moringa oleifera (M.o) seeds, which is rich in phytochemicals with antimicrobials, was tested to produce a natural coagulant capable of clarifying the juice samples. The produced coagulant proved efficient and was potentially characterized by a better environmental performance than the extremely harmful lead acetate. An amount of three grams of M.o seedpowder proved to be an effective coagulant, achieving a 64.14 % removal of non-sugar compounds and led to the correct sugar polarimetric measurements. There is no way to compare the exorbitant price of lead acetate to the cost of naturally and available occurring Moringa seeds. The adsorption process was described by three adsorption isotherms, which were applied to evaluate the adsorption equilibrium.

Cervical spine (CS) fractures or dislocations are medical emergencies that may lead to more serious consequences, such as significant functional disability, permanent paralysis, or even death. Therefore, diagnosing CS injuries should be conducted urgently without any delay. This paper proposes an accurate computer-aided-diagnosis system based on deep learning (AlexNet and GoogleNet) for classifying CS injuries as fractures or dislocations. The proposed system aims to support physicians in diagnosing CS injuries, especially in emergency services. We trained the model on a dataset containing 2009 X-ray images (530 CS dislocation, 772 CS fractures, and 707 normal images). The results show 99.56%, 99.33%, 99.67%, and 99.33% for accuracy, sensitivity, specificity, and precision, respectively. Finally, the saliency map has been used to measure the spatial support of a specific class inside an image. This work targets both research and clinical purposes. The designed software could be installed on the imaging devices where the CS images are captured. Then, the captured CS image is used as an input image where the designed code makes a clinical decision in emergencies.

Span 80 and Tween 80 are biodegradable surfactants that can be added to blended fuels such as hydrated bioethanol–gasoline and methanol–gasoline. They increase the fuels’ water tolerance and reduce their corrosive properties, without altering their fuel characteristics. For this study, a mixture of surfactants Span 80 and Tween 80 was added to create an emulsion and the optimum hydrophilic:lipophilic balance (HLB) was determined. The effect of this additive mixture on spark ignition (SI) engines and the resulting gas emissions were also investigated.Four kinds of fuel mixtures were tested in this study. They were: 10% denatured (DN) ethanol mixed with 90% commercial unleaded gasoline 92 (E10); a blend of 63% commercial unleaded gasoline 92, 17% straight-run naphtha and 20% DN ethanol (E20); 75% commercial unleaded gasoline 80 and 25% DN ethanol (E25); and 9% methanol with 91% commercial unleaded gasoline 92 (M9).The four product blends were compliant with the international standards EN-228 and ASTM-D4814. They also produced good engine performance and reduced amounts of carbon monoxide (CO) and nitrogen oxide (NOx) emissions compared with standard fuels. Keywords: Fuel, DN ethanol, Methanol, Gasoline, Blend, Surfactant, SI engine

Abstract Background/objectives Systemic sclerosis (SSc) is an autoimmune disease associated with immune abnormalities and widespread vascular lesions, including increased intimal and medial thickness. These changes may be reflected in early atherosclerosis and cardiovascular risks. We aimed in this study to examine the carotid artery intima-media thickness and MRI brain findings in SSc patients and compared them to a group of normal controls. A relationship between these parameters and clinical measures in SSc was also sought. Methods Seventy-two SSc patients with no central nervous system (CNS) symptoms and 42 healthy controls were included. Clinical and laboratory measures, Medsger’s severity scale, and Doppler ultrasound common carotid artery intima-media thickness (CCA-IMT) were measured. Brain fluid-attenuated inversion recovery (FLAIR)-MRI and diffusion-weighted MRI (DWI) were also done. Results SSc patients had more CCA-IMT, higher CRP, and more brain MRI hyperintense lesions than controls (P

Background and Objectives: Bacteriocins are considered alternative non-conventional antimicrobials produced by certain bacteria with activity against closely related species. The present study focuses on screening, characterization, and partial purification of bacteriocins produced by Staphylococcus sp. isolated from different clinical sources such as pus and blood. Materials and Methods: A total of 100 Staphylococcus isolates were screened for bacteriocin production using spot on lawn assay and agar diffusion method against five indicator bacteria. Bacteriocins from five selected highly active isolates were subjected to proteinase-K enzyme, different pH, and heating at different temperatures, and investigated the stabilities of their antimicrobials. Two selected isolates, MK65 and MK88, were molecularly identified by 16S rRNA gene sequencing, explored for the presence of 18 bacteriocin genes, and liquid chromatography-high resolution electrospray ionization mass spectrometry (LC-HRESIMS) was used to identify their different metabolites. Results: Twenty isolates exhibited inhibitory effect against at least one indicator bacteria. Micrococcus luteus ATCC 4698 showed the highest sensitivity to such bacteriocins. Proteinase K, acidic pH, and heating at 100°C triggered marked activity inhibition. However, amylase enzyme, alkaline pH, and heating at 80°C caused trivial effects. Four out of eighteen bacteriocin genes were detected using PCR. Fermentation, partial purification, and LC-HRESIMS of total protein extracts of two selected isolates, MK65 and MK88, revealed the production of different antimicrobial peptides. Conclusion: To the best of our knowledge, this is the first study to report the production of micrococcin and α-circulocin from Staphylococcus aureus MK65 and the production of amonabactin from Staphylococcus epidermidis MK88.

The limited amount of freshwater is the most important challenge facing Egypt due to increasing population and climate change. The objective of this study was to investigate how climatic change affects the winter potato water footprint at the Nile Delta covering 10 governorates from 1990 to 2016. Winter potato evapotranspiration (ETC) was calculated based on daily climate variables of minimum temperature, maximum temperature, wind speed and relative humidity during the growing season (October–February). The Mann–Kendall test was applied to determine the trend of climatic variables, crop evapotranspiration and water footprint. The results showed that the highest precipitation values were registered in the northwest governorates (Alexandria followed by Kafr El-Sheikh). The potato water footprint decreased from 170 m3 ton−1 in 1990 to 120 m3 ton−1 in 2016. The blue-water footprint contributed more than 75% of the total; the remainder came from the green-water footprint. The findings from this research can help government and policy makers better understand the impact of climate change on potato crop yield and to enhance sustainable water management in Egypt’s major crop-producing regions to alleviate water scarcity.

Background: The definitive reconstructive technique of the pancreatic stump after pancreaticoduodenectomy (PD) differs among centers. Purpose: The purpose of this study was to evaluate the surgical outcome of stented pancreaticogastrostomy (PG) and the long-term survival after PD in a single center. Patients and Methods: A prospective study of stented PG was performed on 152 patients by the same surgical team over a 7-year period from January 2010 to January 2017. In the early postoperative period, patients were examined for morbidity and mortality related to the procedure. After that, patients were followed up for long-term survival. Results: There were 88 men (57.9%) and 64 women (42.1%); with a mean age of 62.6 (35-87) years. Early postoperative complications occurred in 47 patients (30.9%) including five patients with the pancreatic leak. The survival rate at the end of 1 year, 3 and five years were 80%, 58%, and 42% respectively. Univariate and multivariate analysis revealed that longer survival was found in patients with lower tumor grades and stages, CA 19.9 level less than 100 ng/ml, negative R status and in patients not receiving chemotherapy. Conclusion: The present technique with its low morbidity rate approaches the parameters of an ideal pancreatic anastomotic technique after PD. Factors associated with better survival should be considered for the sake of obtaining the best prognosis. [Arch Clin Exp Surg 2018; 7(4.000): 133-146]

Objective: The purpose of this research was to compare surgical consequences of early versus delayed laparoscopic cholecystectomy for complicated acute calculous cholecystitis. Patients and Methods: This prospective randomized work was conducted on 150 patients complaining of complicated acute calculous cholecystitis; presented to the Emergency Department, Alexandria Main University Hospital, Egypt, between January 2011 and January 2017. They were distributed randomly into two groups (75 patients each): Group (A) for early laparoscopic cholecystectomy and Group (B) for delayed laparoscopic cholecystectomy. Results: There were 42 men and 108 women. Their mean age at diagnosis was 39.6±10.27 years. The timing of surgery since onset of patients complains was ranged from 1.0 to 7.0 days in Group A and from 6 to 10 weeks in Group B. Acute abdominal pain was present in both groups patients. Preoperative CT scan was done for 60 patients (40%) to verify the presence of complications. The mean operative time in Group A and Group B patients were 71.0±26.93 and 38.0±26.25 minutes respectively and there was a statistically significant difference (p>0.054). Laparoscopic cholecystectomy was converted to open procedure in ten patients. The mean hospital stay in patients of Group A was 1.76±1.05 while in patients of Group B was 3.87±2.43 in the first admission and 2.72±1.41 in second admission. There was no major bile duct injury or post-operative obstructive jaundice in either group. In six patients (2 in Group A and 4 in Group B) bile leak was noted from the drain and port sites infections were found in eight patients. Conclusion: Early laparoscopic cholecystectomy one week from start of symptoms of complicated acute calculous cholecystitis; was safe, feasible, and considered an acceptable indication. [Arch Clin Exp Surg 2018; 7(2.000): 47-58]